off record
Shaukat Ali Jawaid

How to say Goodbye
to your loved ones?

Everyone wishes to die peacefully at home if possible but not many are fortunate to get their wish fulfilled. Death in hospital and particularly in Intensive Care Units is very painful for the family where most often none of the close relatives is allowed in case the patient is very serious. Often it is the doctors and nurses who see the patient leaving this world. It is extremely painful and also results in burnout among healthcare professionals, the nurses in particular who are supposed to take care of these seriously ill patients.

During the recently COVID19 pandemic, millions of people died all over the world in hospitals away from their loved ones. This resulted in moral injury to the healthcare professionals and nurses was the most affected one. Moral injury, it may be mentioned here is the term used for combat veterans traumatized from experiencing or doing something which goes against their values. This has highlighted the need to ensure good mental health of these healthcare professionals who have been or are still looking after the Covid19 patients. It is the duty of the hospital administration to ensure that the working hours of those looking after Covid19 patients are drastically reduced so that they can give their best while on duty. Moreover, after working for few days, they must get some break. Numerous studies have now been published on burnout among the doctors and nurses looking after seriously ill patients and the problem has assumed importance during the Covid19 pandemic.

Some institutions have made arrangements for some interventions at the hospital premises. Counselling service should be available easily accessible because country cannot afford to lose these Heroes working on the frontline. Government of Pakistan some time ago did announce some financial assistance for the families of healthcare professionals who died while treating the Covid19 patients but has it been implemented is not known.

While now vaccination against COVID19 is available and many people have got first and second dose as well but vaccine politics refused to die down. Saudi Arabia has announced that those visiting the kingdom must have a vaccine produced in United States and Europe while vast majority of the people in the Low and Middle Income countries are being vaccinated with Chinese vaccine. Vaccine politics has also created problems for those going abroad since the desired vaccine is either not available at all or remains in short supply. It is the responsibility of the World Health Organization to issue guidelines and make sure that any one getting any vaccine which is approved by the WHO is allowed to travel freely. On the other hand the government will also be well advised to eliminate the chances of any shortage of vaccine due to mismanagement. First it was difficult to convince the people to go for vaccination and now when they are willing, they find vaccination centers have been hit with vaccine shortage. It needs efficient administration, sound planning and above all will to overcome the present crisis which has also affected the economic growth and development in the country. Once a significant proportion of people have been vaccinated, the country can have a sigh of relief but this does not mean that we should not follow the SOPs i.e. Use of masks, social distancing and frequent washing of hands. Finally this pandemic has also highlighted the fact that Public Health should never be neglected. Those countries who did so had to see the mortality figures running in millions of people a lot of which was certainly preventable. Timely end of life decisions, shifting the patients off the ventilator, counselling the family members of the patients can also save the family from extensive financial loss. The healthcare professionals should also play their role to ensure peaceful death of the patients in serious condition and consoling the family members. At times decisions by the healthcare facilities are motivated by their commercial interests to prolong the eventual death. This is something which must be avoided keeping up the professional ethics.

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